MEDICARE: SEUNG HAN KIM PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.0008823	CO

General Provider Information

NPI Number	:	1730934555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEUNG HAN KIM PA-C

Provider Business Mailing Address
First Line	:	10120 S 20 MILE RD # 80134
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-5666
Country	:	US
Telephone Number	:	303-228-8871
Fax Number	:

Provider Business Practice Location Address
First Line	:	10120 S 20 MILE RD
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-5666
Country	:	US
Telephone Number	:	303-228-8871
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	12/19/2024

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Directions to “ SEUNG HAN KIM PA-C” Practice Location

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